社区食物环境与儿童肥胖的定性循证研究

朱一民; 朱文丽; 《儿童肥胖预防与控制指南》修订委员会

doi:10.16835/j.cnki.1000-9817.2021.11.004

社区食物环境与儿童肥胖的定性循证研究

doi: 10.16835/j.cnki.1000-9817.2021.11.004

北京大学公共卫生学院，北京 100191

基金项目: 国家卫生健康委员会疾病预防控制局委托项目

详细信息

作者简介:
朱一民(1993-)，女，山东省人，在读硕士，主要研究方向为儿童营养

通讯作者:
朱文丽，E-mail：zhuwenli@bjmu.edu.cn

中图分类号: R179 R723.14 R151.4
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- 被引次数: 0
出版历程
- 收稿日期: 2021-04-21
- 修回日期: 2021-08-31
- 网络出版日期: 2021-12-01
- 刊出日期: 2021-11-25

Evidence-based qualitative study on community food environment and childhood obesity

School of Public Health, Peking University, Beijing(100191), China

摘要

摘要: 目的系统评价社区食物环境与儿童超重肥胖的关系，为相关政策的制定提供循证证据。方法检索1998—2020年公开发表的相关文献，中文数据库为中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台，英文数据库为Cochrane library、PubMed、EMbase等。结果经过文献筛选，共有8篇英文文献纳入本次系统评价，包括3项队列研究和5项横断面研究。结果显示，家庭或学校周边社区的食品商店/餐厅类型、数量、距离、食物价格等与儿童体重、腰围及肥胖风险有关。其中快餐店、便利店、杂货店的数量与儿童肥胖高风险有关，超市、自由市场的数量与儿童肥胖低风险有关。结论社区食物环境与儿童肥胖可能有关，还需要更多高质量研究设计的证据支持。
- 饮食习惯 /
- 肥胖症 /
- 环境 /
- 循征医学 /
- 儿童
Abstract: Objective To systematically evaluate the relationship between the community food environment with overweight and obesity risk in children, and to provide evidence-based evidence for the development of guidelines and policies. Methods Relevant Chinese and English literatures published from 1998 to 2020 were searched in the database of CBM, CNKI, Wanfang Data, Cochrane Library, PubMed, EMbase. Results A total of 8 English literatures were included in this systematic evaluation, including 3 cohort studies and 5 cross-sectional studies. The results showed that the number and type, as well as distance to food stores/restaurants in the neighborhood of family or school were associated with the weight status, waist circumference and obesity risk of children. The number of fast food restaurants, convenience stores, and grocery stores was positively correlated with the risk of childhood obesity, and the number of supermarkets and free markets was associated with a lower risk of overweight and obesity in children. Conclusion The community food environment might be associated with childhood obesity, which is warrented more high-quality scientific evidence.
- Food habits /
- Obesity /
- Environment /
- Evidence-based medicine /
- Child

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表 1 社区食物环境与儿童超重肥胖关系的横断面研究

Table 1. Relations between community food environment and overweight in children: cross-sectional studies

第一作者	研究类型	调查类型/方法	研究对象	样本量	社区食物环境定义	主要结果
Dwicaksono^[7]	横断面研究	普查	学龄儿童	680	超市、农场集市、便利店、快餐店、餐馆	农场集市数量与小学生肥胖呈负相关(β=-0.12，P < 0.01)，快餐店数量与中学生肥胖呈正相关(β=0.01，P < 0.05)。
Green^[8]	横断面研究	既有的相关数据库	11~16岁	336	超市、外卖店以及其他商店(报亭、烘焙店、加油站的便利店)	学校周边1 km范围内其他商店的数量与学龄儿童BMI的SDS评分呈正相关(β=0.04，95%CI=0.01~0.05)。从家至学校道路周围500 m以内的快餐店数量与学龄儿童腰围呈正相关(β=0.02，95%CI=0.01~0.03)。
Gorski^[9]	横断面研究	为期1周的个人访谈、电话访谈、调查册填写	2~18岁	3 748	超级商店、超市、大中型副食商店，复合型杂货店及其他类型的商店(包括独立的药店、一般的商店)，便利店，快餐店，非快餐类餐厅	家周围1 km以内复合型杂货店及其他类型商店数量与儿童超重肥胖呈正相关(OR=1.10，95%CI=1.03~1.17)。
Le^[10]	横断面研究	食物频率调查	10~14岁女生	101	家庭周围步行可及(800 m以内)范围内的杂货店、便利店、快餐店的密度、距离及食物价格	家周围食品店的距离以及密度与儿童肥胖无明显关联。家周围800 m范围内快餐店(OR=0.87，95%CI=0.77~ 0.99)及杂货店(OR=0.97，95%CI=0.95~0.99)内健康食物的价格与儿童肥胖呈正相关。
Matanane^[11]	横断面研究	2 d的食物活动日志	2~8岁	466	家周围1 km以内的食物环境(小市场、便利店、大型杂货店或大型超市)	居住于小市场周围的儿童BMI-Z评分较低，而便利店周围儿童BMI-Z评分则较高。

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表 2 社区食物环境与儿童超重肥胖关系的队列研究

Table 2. Relations between community food environment and overweight in children: cohort studies

第一作者	研究设计	研究对象	样本量	社区食物环境定义	主要结果
Jia^[13]	队列研究(追踪9年)	幼儿	7 530	学校周边800 m范围内食品店/餐厅的类型和数量。学校周边便利店数量增加与儿童较高BMI有关，尤其是城市儿童	乳制品店数量减少、快餐店/便利店数量增加与儿童较高的肥胖风险有关，而综合性餐厅数量增加、肉/鱼市场减少与儿童肥胖风险降低有关。
Shier^[15]	队列研究	12~13岁	1 188	以家为中心某半径范围内出现的商店种类及数量	食品商店的类型及分布和儿童BMI无明显关联。
Chen^[12]	队列研究(随访3年)	青春期前的儿童	7 090	各个编码区域内4种商店类型：超市、限制服务型餐馆、小型杂货店、便利店	与社区无超市相比，社区超市数量≥3时，女孩3年后的BMI较低(-0.62 kg/m²)，而限制服务类餐馆数量>1时，女孩3年后的BMI值更高(1.02 kg/m²)。社区中小型商店数量减少与女孩BMI降低有关。

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